Minimally invasive spine surgery for thoracolumbar fractures: Damage-control spine stabilization

In North America, spinal injuries from blunt trauma occur with an incidence rate of approximately 6%. The vast majority of spinal column injuries occur at the thoracolumbar spine, predominantly at the thoracolumbar junction (T10–L2). The conventional surgical treatment for thoracolumbar fractures involves open exposure with placement of instrumentation with fusion. These conventional surgeries in trauma patients, however, have significantly higher infections rates and higher blood loss when compared to open spinal surgeries in non-trauma patients. Because of these complications, minimally invasive spinal surgery (MISS) techniques have been advanced as a viable alternative to the conventional open spinal surgeries. The goals of both approaches (open and MISS) are to stabilize the spine in order to prevent posttraumatic deformity and to prevent development of neurologic deficits. MISS techniques can achieve these goals while avoiding the increased complications associated with traditional open surgeries. Furthermore, MISS techniques may be an excellent solution in the polytrauma patients, providing “damage-control spinal stabilization.”